Abstract

We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone
mimicking a metastatic carcinoma. A 74-year-old female with a 15-year history of rheumatoid
arthritis (RA) on treatment with methotrexate presented with tenderness of the right
base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies
were unsuccessful and the patient required surgical resection of the mass. A trans-cervical
approach was used. Pathology revealed a necrotizing granuloma compatible with rheumatoid
etiology. The clinician should be aware that, in a patient with a neck mass, in the
presence of active RA, rheumatoid nodules should be part of the differential diagnosis.